Drug & supplement interaction

Cassia Cinnamon + Duloxetine

Duloxetine brand names: Cymbalta, Drizalma Sprinkle, Irenka.

Moderate Interaction
The bottom line Moderate

Cassia Cinnamon has a moderate interaction with Duloxetine. Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cassia Cinnamon and Duloxetine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

HEPATOTOXIC DRUGS

Why this applies to Duloxetine

Duloxetine falls under HEPATOTOXIC DRUGS — the group Cassia Cinnamon interacts with.

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the connection with Cymbalta (duloxetine): this is about your liver, not about how the drug is broken down. Duloxetine carries a known, though uncommon, risk of liver irritation on its own. Cassia cinnamon naturally contains coumarin, and taking large supplement doses for a long time may also stress the liver. Put the two together and the worry is simply additive strain on the same organ.

To be clear, this is theoretical, based on how these compounds behave, not on confirmed cases. Sprinkling cinnamon on your oatmeal is no concern. The caution is for concentrated, daily cassia supplements, especially if you already have liver issues. Watch for yellowing skin, dark urine, belly pain, or unusual fatigue, and check with your pharmacist or doctor before starting a high-dose product.

References
  1. Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
  2. Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
  3. Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
  4. Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep 2015;16:250-4. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cassia Cinnamon Also Interacts With Other Medications

Cassia Cinnamon has 441 moderate known drug interactions in our database — the Duloxetine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cassia Cinnamon

Covers the 2,830 medications we’ve checked against Cassia Cinnamon. Pick one to open its full report.

From our Q&A

Questions About Cassia Cinnamon or Duloxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cassia Cinnamon or Duloxetine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Duloxetine

This page covers Cassia Cinnamon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Duloxetine page lists 132 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Lithium (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 107 moderate · 20 minor.

Open the Duloxetine interaction page

One more smart check

Taking Cassia Cinnamon as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,249 real supplement products containing Cassia Cinnamon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cassia Cinnamon. Your product may carry other ingredients that interact with Duloxetine too, on top of Cassia Cinnamon — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cassia Cinnamon and Duloxetine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cassia Cinnamon
Top 10%

#77 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Duloxetine
Top 5%

#47 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cassia Cinnamon

What is Cassia Cinnamon?

Cassia Cinnamon
  • Blood sugar support
  • Digestive upset
  • Antioxidant support
  • Flavoring and culinary use
  • Antimicrobial

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed and far from proven, and because cassia is naturally high in coumarin, taking large amounts regularly may stress the liver. Use food amounts freely, but talk with a pharmacist or doctor before using high-dose supplements.

Read the full Cassia Cinnamon monograph & all interactions
Medication

About Duloxetine

What Is Duloxetine Used For?

Brand names: Cymbalta, Drizalma Sprinkle, Irenka

Duloxetine delayed-release capsules treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults. They also manage diabetic peripheral neuropathic pain (nerve pain from diabetes), fibromyalgia, and chronic musculoskeletal pain (such as chronic low back pain and pain from osteoarthritis) in adults.

GAD is also approved in pediatric patients 7 years and older for Cymbalta, Drizalma Sprinkle, and certain duloxetine delayed-release capsule products. Fibromyalgia is approved in patients 13 years and older for Cymbalta and some duloxetine delayed-release capsule products. Age-specific approvals vary by product — follow your prescriber's guidance on which product is right for your age group.

See full Duloxetine drug information
Keep checking

Other Drugs & Cassia Cinnamon

Browse every other medication we’ve checked against Cassia Cinnamon — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
441Moderate
0Minor
2,388No known interaction
Moderate

441 interactions

Showing 60 of 441 moderate interactions — see all 441 on the Cassia Cinnamon page.

No interaction 2,388 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Cassia Cinnamon and Duloxetine Together: Common Questions

Can you take Cassia Cinnamon with Duloxetine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cassia Cinnamon and Duloxetine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.